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General NPI Number Information
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NPI Number | 1114310331
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Entity Type | Organization
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Legal Business Name | PREVENTIVE NEPHROLOGY, PA
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Dates
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Enumeration Date | 03/12/2015
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Last Update Date | 03/12/2015
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Provider Practice Location Address
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Address Line | 5050 COUNTY ROAD 472
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City | OXFORD
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State | FL
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Zip | 34484-3750
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Country | US
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Telephone | 305-705-9922
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Fax |
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Provider Business Mailing Address
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Address Line | 1218 HOWARD RD
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City | LEESBURG
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State | FL
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Zip | 34748-8320
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Country | US
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Telephone | 305-705-9922
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID WILLIAM MOSKOWITZ
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Credential | M.D.
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Telephone | 305-705-9922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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